A Modest Proposal revisited

Back in the early 1700’s, Irish satirist Jonathan Swift sought to redress the suffering of his impoverished countrymen with a simple suggestion. In a parody of careful reasoning, Swift proposed that they sell their infant children to the English for use as food, going so far as to suggest that Irish babies would quickly become a delicacy and fetch a good price.

Something of the same reasoning, it seems, lies behind Republican efforts to repeal and replace Obamacare. Indeed, the only thing such efforts lack vis a vis the Swift argument is the wit of its dark humor. With the frenzied release and promotion of their new plan, the GOP leadership has employed the same tortured logic to sell an equally absurd proposition: namely, that health insurance does not, and should not, oblige healthy people to defray the medical expenses of the sick, a premise that flies in face of an entire business model.

What modern Republicans have in common with the English upper classes at whom Swift aimed his attack is a deep sense of moral superiority compounded by an ample dollop of racism. How else can one explain their insistence on calling the existing plan Obamacare, as well as their frantic efforts to prevent its replacement from being named for one of their own?

Equally scurrilous is the faux conservatism they employ in support of their alternative plan, which Speaker Ryan assures us will be cheaper and fairer and, above all, prevent the government from forcing us to buy insurance in the first place, again defying a business model which has always depended on economies of scale to keep prices down. Then too, he neglects to mention that government regulation of the industry is more often than not the only thing preventing insurers from using “fine print” specifications to the detriment of unwitting consumers.

As one listens to Ryan’s confounding arguments for tax incentives as opposed to access to expanded Medicaid (the eyes glaze over at the very words), one thing comes to mind as the only real panacea for the morass of complexities that have evolved around this critical component of modern life. Instead of wading into the unfathomable numbers games of competing plans, how much easier it would be to adopt a single-payer, government-run plan coupled with a sufficiently progressive tax structure to pay for it (with the added benefit of reducing the growing income disparity that threatens to destroy our democracy).

Republicans can recite their twaddle about the freedom of choosing one’s own healthcare plan all they like, but at this point the only freedom Americans truly desire is the freedom of a system in which their lives no longer depend upon acquiring a detailed understanding of the insurance business. There are so many better, more important things to think about.